Cancer and the Environment projects with four First Nations organizations: working together to address concerns about carcinogens in the environment.

SETTING: For First Nations people, human health and well-being are interconnected with a healthy environment. First Nations organizations commonly raise concerns regarding carcinogens in the environment; however, few case studies are available as guidance for working in a participatory and respectful way to help assess and address these concerns. INTERVENTION: Through four community-led pilot projects executed over two years, we collaborated with 15 participants from four First Nations organizations across four provinces to identify concerns related to environmental carcinogens and to address those concerns through an integrated knowledge translation (KT) approach. We co-developed and implemented strategic KT plans for each pilot project, and conducted evaluation surveys and interviews with participants at multiple time points to assess process, progress, barriers and facilitators, and impact. OUTCOMES: The activities and outputs of the pilot projects are available at www.carexcanada.ca . Participants identified 18 concerns, and we co-developed 24 knowledge products. Tailored fact sheets for communities and briefing notes for leadership were deemed most useful; interactive maps were deemed less useful. Evaluation indicated that the collaborative projects were effective in addressing the concerns raised regarding exposures to carcinogens. IMPLICATIONS: The participant-led approach and multi-year funding to support capacity enhancement and face-to-face engagement were facilitators to project success. However, participants did face important barriers to collaborate which should be considered in future projects of this kind: the most important being a lack of resources (people and time), given competing and often more urgent priorities.

RéSUMé: LIEU: Pour les Premiers Peuples, la santé et le bien-être humains sont indissociables de la santé de l'environnement. Les organismes des Premières Nations se disent souvent préoccupés par les cancérogènes présents dans l'environnement, mais peu d'études de cas sont disponibles pour apprendre à travailler de façon participative et respectueuse à évaluer ces préoccupations et à y répondre. INTERVENTION: Dans le cadre de quatre projets pilotes de proximité menés sur une période de deux ans, nous avons collaboré avec 15 participants, issus de quatre organismes des Premières Nations dans quatre provinces, à cerner leurs préoccupations liées aux cancérogènes dans l'environnement et à y répondre selon une démarche intégrée d'application des connaissances. Nous avons conjointement élaboré et mis en œuvre des plans stratégiques d'application des connaissances pour chaque projet pilote et mené des sondages d'évaluation et des entretiens avec les participants à plusieurs reprises pour évaluer le processus, les progrès accomplis, les éléments favorables et défavorables et les impacts des projets. RéSULTATS: Les activités et les extrants des projets pilotes sont présentés sur le site www.carexcanada.ca . Les participants ont exprimé 18 motifs de préoccupation, et nous avons élaboré avec eux 24 produits du savoir. Les fiches d'information adaptées à chaque communauté et les notes d'information pour les dirigeants ont été jugées très utiles, mais les cartes interactives un peu moins. Selon l'évaluation, les projets collaboratifs ont réussi à répondre aux préoccupations soulevées quant à l'exposition aux cancérogènes. CONSéQUENCES: La démarche axée sur les participants et le financement pluriannuel consacré au renforcement des capacités et aux contacts directs ont été des éléments favorables à la réussite des projets. Par contre, les participants ont fait face à d'importants obstacles à la collaboration dont il faudrait tenir compte dans les futurs projets de la sorte, le principal obstacle étant le manque de ressources (personnes et temps), étant donné l'existence de priorités concurrentes et souvent plus urgentes.

LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program.

INTRODUCTION: The prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved. METHODS: We conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed. RESULTS: Overall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness. CONCLUSIONS: This study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing. IMPLICATIONS: This study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies for this population is needed. Findings from this study can assist practitioners and researchers in designing interventions.